When attaching implants, such as artificial knee, elbow, finger or hip joints, it is required that the implant, such as a joint or part of a bone, is positioned as accurately as possible onto the adjacent bone. For this, the most accurate possible incisions must be made to the bone structures adjacent to the joint.
Referring to FIGS. 20A and 20B, U.S. Pat. No. 6,551,325 B2 discloses that a tibial incision block 100 is navigated onto a bone K using a positioning element inserted into a guide slit 100a. Then this incision block 100 can be fixed to the bone K with suitable fixing or holding elements 101. Using a cutting tool 102, a desired incision in the incision plane S0 can be made either by placing a blade on the upper side of the incision block 100, as shown in FIG. 20A or by guiding a blade in the guide slit 100a, as shown in FIG. 20B.
A drill template can be positioned by a reference star on the incision plane S0 shown in FIG. 20A in such a way that suitable tools for creating a connecting structure between the bone and the incision block, for example holding elements 103, are inserted through holes into the bone K, such that a second incision block 104, as shown in FIG. 21, can be correctly positioned by attaching it to the holding elements 103. In the same way, a holding element 103, for example, also can be firmly connected to the incision block 104 in such a way that the incision block 104 can be inserted into holes drilled into the bone K with the aid of the drill template, using the holding elements 103. Once the second incision block 104 has been placed in the desired position, the desired incisions in the planes S1 to S4 may be made through the various guide slits provided in the second incision block 104.
An artificial joint can be attached onto the bone, in which the desired incision planes S0 to S4 have been created with the help of the first incision block 100 and the second incision block 104, said joint being correctly positioned when the location of the incision planes S0 to S4 is correct.
US 2006/0036257 A1 discloses a tibial spacer block used during knee arthroplasty and configured to be temporarily positioned upon a resected proximal portion of a tibia for performing a range of motion analysis and for checking flexion and extension gaps prior to cutting the distal or posterior femur. The spacer block includes an attachment arrangement configured and arranged to mate with a complementary attachment arrangement of an alignment tower and/or a femoral cutting guide. The alignment tower, which is configured to be used with an alignment rod, can be used for verifying the alignment of the limb's mechanical axis when the spacer block is positioned between the tibia and the femur. The femoral cutting guide can be used for guiding a cutting member into proper orientation for resecting a distal or posterior portion of a femur.
DE 103 35 388 A1 discloses that an area in which a surgical procedure is to be performed is connected to a navigation system with several transmitting and receiving devices. A marker in the shape of a rigid body is joined to the femur with a unit assembled of a sleeve and a holding element. The sleeve is fitted with a cylindrical extension with a conical tip, engaging with a matching recess located at a bone plate attached to the femur in order to facilitate a safe connection.
DE 100 31 887 A1 discloses an optical system that detects anatomical parameters of a leg of a patient and detects leg movement data indicative of the original movement range of the leg. A computer system determines the original knee kinematics for the knee to be treated from the detected anatomical parameters and the movement data, and selects prostheses for the knee based on the original knee kinematics.
U.S. Pat. No. 4,566,448 discloses a ligament tensor and distal femoral resector guide which includes an adjustable support member for mounting on a tibial cutting guide including a guide slot in which is reciprocally mounted a slide member. The slide member has an arm extending outward therefrom for engaging the condylar notch between the femoral condyles and a screw member. The screw member threadably engages the slide member and can be used for adjusting the position of the slide member and arm relative to the tibia cutting guide head to establish tension in the ligaments of a knee structure. A flat pressure plate is removably mounted in the slots of the tibia cutting guide head for engaging the sectioned tibia plateau for applying pressure to the tibia for tensioning of the ligaments. A cutting guide head for guiding the resection of distal femoral condyles is mounted on the adjustable support member.
US 2005/0149037 A1 discloses a cut block for cutting the femur and tibia during knee replacement surgery.
U.S. Pat. No. 5,911,723 discloses a surgical tensioning apparatus that has a base, first and second bone tissue engaging elements mounted on the base and being displaceable toward and away from each other. One of the tissue engaging elements is adapted to be oriented by the tissue engaged thereby. A guide element is provided that is adjustable in relation to the base and one of the tissue engaging elements for positioning a first location element to locate a cutting guide provided with cooperating second location element onto the bone to be resectioned.